MILWAUKEE — A white supremacist with a history of alcohol problems had no drugs in his system when he walked into a Sikh temple in suburban Milwaukee this summer and fatally shot six people before killing himself, according to a toxicology report released Wednesday.

There were small amounts of alcohol in Wade Michael Page’s heart, but because there was none in his bloodstream the alcohol may have been produced after Page’s body tissues began breaking down, a Milwaukee County pathologist said.

“It is impossible to tell if the ethyl alcohol level is due to alcohol ingestion or a product of decomposition,” Agnieszka Rogalska said in an email.

Page’s sister had told investigators that in the year preceding the rampage, her brother developed a bloated appearance that made her wonder if he’d been drinking recently. She also said Page seemed to grow more intense over the past year, as if he had lost his wit and sense of humor, according to an investigative report.

Page, 40, opened fire Aug. 5 before a service was to start at the Sikh Temple of Wisconsin in suburban Milwaukee. He killed six people and wounded four others before he was shot in the abdomen during a firefight with police. He died after he shot himself in the head.

The Milwaukee County medical examiner’s office, which released the investigative report, officially ruled his death a suicide.

Page’s sister told authorities her brother didn’t use drugs but had a history of alcohol problems. He was cited several times over the years for his drunken behavior, and was convicted in Colorado of drunken driving in 1999 and in Texas in 2004 for drunkenly kicking holes in an El Paso bar’s walls.

Page had gotten several tattoos associated with the white supremacy movement, including the number 14 on his left shoulder and the number 88 on his right one, according to an Aug. 6 autopsy report that had been kept under seal until the FBI completed its investigation Tuesday. In white-supremacist circles, “14” represents the 14 words in a popular skinhead mantra. The number “8” points to “H” as the eighth letter of the alphabet, and 88 is a reference to, “Heil Hitler.”

He also had tattoos of skulls and crossbones on one forearm, flames on his lower leg and the words “Suffer” across his shoulders and “Pride” on his upper chest. He also had four letters that abbreviate a profane statement tattooed on the knuckles of his left hand.

The FBI issued a four-page statement Tuesday saying the agency had concluded its investigation into the rampage and found no evidence to suggest Page had any help or was carrying out any directive from any white-supremacist group. Investigators also found nothing to suggest the attack was part of any ongoing threat to the Sikh community.

The statement did not mention any motive, and the bureau didn’t release any supporting or supplemental documents. The FBI has said previously Page’s motive may never be known.